Attachment A: Impl Attachment A: Implementation Survey

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Implementation Survey

Consent to Participate

The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) is sponsoring a multi-site evaluation of the Advancing Wellness and Resilience in Education (AWARE) and Trauma-Informed Services in Schools (TISS) programs. AWARE provides funding to strengthen school-based mental health programs and build partnerships to ensure that students have access and are connected to appropriate and effective behavioral health services. TISS is designed to increase student access to trauma support services and mental healthcare by developing innovative approaches to link school systems with local support and mental health systems.

This survey includes questions about the planning, organization, and provision of services that are part of the AWARE and/or TISS program in your state and preparation for program sustainability. The survey assesses the development and implementation of evidence-based services for students as part of the grant, any successes or challenges related to the provision of services, and efforts to improve the coordination of services and collaboration among schools, communities, and families. As a person who has a role in these activities, your perspective is important to us. The survey will take approximately 25 minutes to complete.

Your participation in this survey is completely voluntary and will not result in any direct benefits to you. However, your input will help to inform the development of mental health services for students in your state or beyond. We do not anticipate any risks to you related to participating in this survey.

We will not associate your name with the information that you provide. We will not share any identifying information in any reports or presentations that include findings from this survey. Only members of the research team will have access to study information.

In appreciation of your participation, you will receive a $20 gift card upon completion of the survey.

If you have questions about this initiative, please contact the Project Director, Dr. Colleen Murray, at [email protected]. For questions regarding your rights related to survey participation, you can contact ICF’s Institutional Review Board (IRB) at [email protected].

* Please choose one of the options below and click “next” to confirm:

I have read the above information and I AGREE to participate in this survey.

I have read the above and I DO NOT wish to participate in this survey.

Demographics

1. Your state:
[DROP DOWN OPTIONS]

2. What is your primary role?

◯ Grant project coordinator

◯ Program director or program manager

◯ Program partner

◯ School-based staff (e.g., principal, teacher, counselor, social worker, psychologist, etc.)

◯ Other (please specify)

3. What is your secondary role?

◯ Not applicable, I do not have a secondary role

◯ Grant project coordinator

◯ Program director or program manager

◯ Program partner

◯ School-based staff (e.g., principal, teacher, counselor, social worker, psychologist, etc.)

◯ Other (please specify)

4. How many years have you been in your primary role? ____

5. Where is your primary assignment?
◯ In a school or schools
◯ In the community
◯ Time is split evenly between a school or schools and the community

◯ In an education agency office
◯ Other (please specify)

Part I: The School Mental Health Capacity Instrument

The following items are about the systems, protocols, and policies supported by your AWARE and/or TISS program to address student mental health concerns (including trauma). Please rate the extent to which participating schools currently reflect or address each item.	Not at all	A little bit	To some extent	To a great extent	Insufficient knowledge to respond
1. When there is a concern about a student's mental health, there are efforts to communicate with the family.	1	2	3	4	5
2. There is a system in place to take action on referrals for students with a mental health concern.	1	2	3	4	5
3. A professional is available to perform an assessment for students who have been referred for a mental health concern.	1	2	3	4	5
4. There is a clearly designated person for families to contact when they have a concern about a student's mental health.	1	2	3	4	5
5. School staff make an effort to understand how the stressors students experience outside of school are related to specific problems they may experience in school.	1	2	3	4	5
6. There is a group of staff that meets regularly to discuss students with mental health concerns.	1	2	3	4	5
7. There are programs or structures in place that enable staff to proactively identify students who may be experiencing challenges related to their mental health.	1	2	3	4	5
8. There are regular opportunities set aside for staff to discuss the social, emotional, and mental health needs of students.	1	2	3	4	5
9. Students are given regular opportunities to be aware of their own and other’s talents and accomplishments.	1	2	3	4	5
10. The schools’ mission and philosophy reflect an explicit focus on the social and emotional development of students.	1	2	3	4	5
11. There are activities or programs that focus on building students’ strengths and resilience.	1	2	3	4	5
12. When students begin exhibiting social or emotional challenges, staff intervene to try to address the root problems or stressors.	1	2	3	4	5
13. There are resources or services available for students who may be experiencing mental health challenges associated with depression, anxiety, loss, trauma, or other issues.	1	2	3	4	5
14. Families are part of efforts to prevent future mental health problems.	1	2	3	4	5
15. There are activities or programs that provide students with information about “normative” development, such as friendship, puberty, or career possibilities.	1	2	3	4	5
16. Staff are knowledgeable about how to talk about students’ emotional and psychological well-being.	1	2	3	4	5
17. There are professional development opportunities offered to staff that are specifically related to mental health.	1	2	3	4	5

School Mental Health Quality Assessment Questionnaire (SMHQAQ)

Please review the items below and select the number that best reflects the degree to which the policy or practice is implemented in schools participating in your AWARE and/or TISS program.	Not at all in place	Plan to implement	Began Implementing	Made some progress	Made significant progress	Fully in place	Insufficient knowledge to respond
1. When indicated, case management assistance is provided to students and families to facilitate enrollment in mental health programs or services for which they are eligible.	1	2	3	4	5	6	7
2. Staff members in the school are engaged in activities that may bring resources or financial support into the school mental health program.	1	2	3	4	5	6	7
3. Assessments are conducted on common risk and stress factors faced by students (e.g., exposure to crime, violence, substance abuse).	1	2	3	4	5	6	7
4. Meetings are held with students and parents to assess their needs related to student mental health and to solicit recommendations for actions school staff can take to promote student mental health.	1	2	3	4	5	6	7
5. Services are in place to help students contend with common risk and stress factors.	1	2	3	4	5	6	7
6. School staff attempt to connect students and parents to mental health resources and services designed to meet their needs based on an initial needs assessment.	1	2	3	4	5	6	7
7. Ongoing training and supervision is provided for mental health clinical staff (within schools or partner organizations) on effective diagnosis, treatment planning, and subsequent clinical decision-making to address student mental health needs.	1	2	3	4	5	6	7
8. Screening and follow-up assessments are conducted to assist in the early identification and appropriate diagnosis of student mental health challenges.	1	2	3	4	5	6	7
9. Staff members continually assess whether mental health services provided to students are appropriate and helping to address presenting problems.	1	2	3	4	5	6	7
10. There is a clear and effective protocol in place to assist clinical decision making and care in the case of abuse and neglect reports and self-reporting of suicidal or homicidal ideation.	1	2	3	4	5	6	7
11. Staff members actively use the evidence-base (practices and programs) and knowledge of what works in child and adolescent mental health to guide preventive and clinical interventions.	1	2	3	4	5	6	7
12. The schools have developed advisory boards (including youth, families, administrators, educators, school health staff, and community leaders) to guide the development and implementation of mental health programs.	1	2	3	4	5	6	7
13. AWARE and/or TISS grant project coordinators collaborate closely with school administrators and offer opportunities for recommendations, feedback, and involvement in program development and implementation.	1	2	3	4	5	6	7
14. School administrators or others solicit feedback (e.g., through meetings, focus groups, or surveys) from parents, students, teachers, and other stakeholders related to how the AWARE and/or TISS program is functioning and how it can be improved.	1	2	3	4	5	6	7
15. Schools engage in efforts to ensure that stakeholder ideas and recommendations related to improving the AWARE and/or TISS program are implemented in a timely manner.	1	2	3	4	5	6	7
16. Training and educational activities related to student mental health are provided for families, teachers and other stakeholder groups based on their recommendations and feedback.	1	2	3	4	5	6	7
17. School staff efforts and activities are guided by quality assessment and improvement plans made available to the school community.	1	2	3	4	5	6	7
18. School staff members are trained on protocols related to confidentiality associated with student mental health.	1	2	3	4	5	6	7
19. Clinical staff within schools or partner organizations ensure that families are meaningfully involved in treatment planning and ongoing therapy.	1	2	3	4	5	6	7
20. An evaluation plan has been implemented that provides measurable results to guide and improve preventive and clinical intervention efforts designed to promote student mental health.	1	2	3	4	5	6	7
21. Evaluation findings are shared with youth, families, school staff and other stakeholders.	1	2	3	4	5	6	7
22. Schools offer activities promoting school-wide mental health.	1	2	3	4	5	6	7
23. Schools are actively involved in developing and implementing training and educational activities for educators on the identification, referral, and behavior management of student social, emotional, and behavioral challenges.	1	2	3	4	5	6	7
24. Schools offer intensive mental health treatment services for students and families including individual, group, and family therapy.	1	2	3	4	5	6	7
25. Referral procedures are well utilized by educators, other mental health staff, health staff, administrators, parents and students.	1	2	3	4	5	6	7
26. All students who have been referred for services are promptly screened/assessed.	1	2	3	4	5	6	7
27. Staff members are sufficiently trained, supported, and supervised to handle the unique demands of school-based practice in an ethical manner.	1	2	3	4	5	6	7
28. Services are characterized by a flexible, proactive approach that enables students and families in need to be served as rapidly as possible.	1	2	3	4	5	6	7
29. Staff members receive regular training on effectively providing care for students and families who present diverse developmental, cultural, ethnic, and personal backgrounds.	1	2	3	4	5	6	7
30. School mental health programs and services are welcoming and respectful to the students and families served.	1	2	3	4	5	6	7
31. Key stakeholders who provide ongoing guidance to school mental health programs are diverse in terms of gender, race/ethnicity, and personal/cultural background.	1	2	3	4	5	6	7
32. Staff members help to coordinate mental health efforts in the school to ensure that youth who need services receive them.	1	2	3	4	5	6	7
33. Staff members use or help to develop communication mechanisms to ensure that information is appropriately shared and that student and family confidentiality is protected.	1	2	3	4	5	6	7
34. There is active collaboration between professionals across schools (health/mental health providers, educators, administrators).	1	2	3	4	5	6	7
35. Staff members are knowledgeable about existing mental health and related resources for students in the school and community and this information is readily available in a directory that can be broadly shared within the school.	1	2	3	4	5	6	7
36. Schools are working closely with other community health and mental health providers and programs to improve cross-referrals, enhance linkages, and coordinate and expand resources.	1	2	3	4	5	6	7

Part II: Mental Health Integration Survey (MHIS)

Please indicate your agreement / disagreement with the following statements.	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Insufficient knowledge to respond
1. School administrators encourage school personnel to work together to address student mental health needs.	1	2	3	4	5	6
2. Mental health services are important in the school setting independent of academic success.	1	2	3	4	5	6
3. There are clear, designated procedures or a clear authority for referral when students have mental health needs.	1	2	3	4	5	6
4. There are clear, designated procedures or a clear authority for referral when students have drug abuse service needs.	1	2	3	4	5	6
5. Student service professionals share responsibilities when addressing student mental health needs.	1	2	3	4	5	6
6. Schools support or encourage efforts to provide trauma-informed mental health services.	1	2	3	4	5	6
7. Structural supports exist (i.e. resources, funding, organization) to support mental health services for students in the schools.	1	2	3	4	5	6
8. The schools offer flexibility in schedules or assignments to adequately assist students who have mental health needs.	1	2	3	4	5	6
9. The schools’ responsibility includes addressing needs for students with diagnosed mental health conditions.	1	2	3	4	5	6
10. Mental health promotion services are available for all students, even if they do not have a diagnosis.	1	2	3	4	5	6
11. The AWARE and/or TISS program facilitates incorporating students from diverse backgrounds and cultures.	1	2	3	4	5	6

Part IV. Program Sustainability Assessment Tool

In the following questions, please rate your AWARE and/or TISS program across a range of specific factors that affect program sustainability. Please respond to as many items as possible. For each statement, select the number that best indicates the extent to which your program has or does the following things.

Environmental Support: Having a supportive internal and external climate for the AWARE and/or TISS program	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a more than moderate extent	To a great extent	To a very great extent	Not able to answer
1. Champions exist who strongly support the program.	1	2	3	4	5	6	7	8
2. The program has strong champions with the ability to garner resources.	1	2	3	4	5	6	7	8
3. The program has leadership support from within the larger school system.	1	2	3	4	5	6	7	8
4. The program has organizational leadership support from outside of the school.	1	2	3	4	5	6	7	8
5. The program has strong school community support.	1	2	3	4	5	6	7	8

Funding Sustainability: Establishing a consistent financial base for the AWARE and/or TISS program	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a more than moderate extent	To a great extent	To a very great extent	Not able to answer
1. The program exists in a supportive state economic climate.	1	2	3	4	5	6	7	8
2. The program implements policies to help ensure sustained funding.	1	2	3	4	5	6	7	8
3. The program is funded through a variety of sources.	1	2	3	4	5	6	7	8
4. The program has a combination of stable and flexible funding.	1	2	3	4	5	6	7	8
5. The program has sustained funding.	1	2	3	4	5	6	7	8

Partnerships: Cultivating connections between the AWARE and/or TISS program and its stakeholders	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a more than moderate extent	To a great extent	To a very great extent	Not able to answer
1. Diverse community organizations are invested in the success of the program.	1	2	3	4	5	6	7	8
2. The program communicates with community leaders.	1	2	3	4	5	6	7	8
3. Community leaders are involved in the program.	1	2	3	4	5	6	7	8
4. Community members are passionately committed to the program.	1	2	3	4	5	6	7	8
5. The school community is engaged in the development of program goals.	1	2	3	4	5	6	7	8

Organizational Capacity: Having the internal support and resources needed to effectively manage the AWARE and/or TISS program and its activities	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a more than moderate extent	To a great extent	To a very great extent	Not able to answer
1. The program is well integrated into the operations of the school.	1	2	3	4	5	6	7	8
2. Organizational systems are in place to support the various program needs.	1	2	3	4	5	6	7	8
3. School leadership effectively articulates the vision of the program to external partners.	1	2	3	4	5	6	7	8
4. School leadership efficiently manages staff and other resources.	1	2	3	4	5	6	7	8
5. The program has adequate staff to complete the program’s goals.	1	2	3	4	5	6	7	8

Program Evaluation: Assessing the AWARE and/or TISS program to inform planning and document results	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a more than moderate extent	To a great extent	To a very great extent	Not able to answer
1. The program has the capacity for quality program evaluation.	1	2	3	4	5	6	7	8
2. The program reports short-term and intermediate outcomes.	1	2	3	4	5	6	7	8
3. Evaluation results inform program planning and implementation.	1	2	3	4	5	6	7	8
4. Program evaluation results are used to demonstrate successes to funders and other key stakeholders.	1	2	3	4	5	6	7	8
5. The program provides strong evidence to the public that the program works.	1	2	3	4	5	6	7	8

Program Adaptation: Taking actions that adapt the AWARE and/or TISS program to ensure its ongoing effectiveness	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a moder than moderate extent	To a great extent	To a very great extent	Not able to answer
1. The program periodically reviews the evidence base.	1	2	3	4	5	6	7	8
2. The program adapts strategies as needed to improve effectiveness.	1	2	3	4	5	6	7	8
3. The program adapts to new science.	1	2	3	4	5	6	7	8
4. The program proactively adapts to changes in the environment.	1	2	3	4	5	6	7	8
5. The program makes decisions about which components should not continue because they are ineffective.	1	2	3	4	5	6	7	8

Communications: Strategic communication with stakeholders and the public about the AWARE and/or TISS program	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a more than moderate extent	To a great extent	To a very great extent	Not able to answer
1. The program has communication strategies to secure and maintain public support.	1	2	3	4	5	6	7	8
2. Program staff communicate the need for the program to the public.	1	2	3	4	5	6	7	8
3. The program is marketed in a way that generates interest.	1	2	3	4	5	6	7	8
4. The program increases awareness of the issue.	1	2	3	4	5	6	7	8
5. The program demonstrates its value to the public.	1	2	3	4	5	6	7	8

Strategic Planning: Using processes that guide the AWARE and/or TISS program’s direction, goals, and strategies	To little or no extent	To a very small extent	To a small extent	To a moderate extent	To a more than moderate extent		To a great extent	To a very great extent	Not able to answer
1. The program plans for future resource needs.	1	2	3	4	5	6		7	8
2. The program has a long-term financial plan.	1	2	3	4	5	6		7	8
3. The program has a sustainability plan.	1	2	3	4	5	6		7	8
4. The program’s goals are understood by all stakeholders.	1	2	3	4	5	6		7	8
5. The program clearly outlines roles and responsibilities for all stakeholders.	1	2	3	4	5	6		7	8

References

Feigenberg, Watts, and Buckner (2010) The School Mental Health Capacity Instrument: Development of an Assessment and Consultation Tool. School Mental Health. 2:142-154.

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